Fri Apr 08 2022

69 articles - From Saturday Apr 02 2022 to Friday Apr 08 2022

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Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…


Meta-analysis

meta-analyses and systematic reviews


Original articles

RCT, clinical trials, retrospective studies, etc…

Ann Intern Med

After DES implantation, DAPT for 1 y vs. =6 mo increased major bleeding in patients with high baseline bleeding risk.

Source citation Palmerini T, Bruno AG, Redfors B, et al J Am Coll Cardiol. 2021;78:1968-86. 34763774.

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Antihypertensive drugs reduced risk for new-onset type 2 diabetes; effect varies by antihypertensive class.

Source citation Nazarzadeh M, Bidel Z, Canoy D, et al Lancet. 2021;398:1803-10. 34774144.

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Changes in Health Care Spending, Use, and Clinical Outcomes After Nonfatal Firearm Injuries Among Survivors and Family Members : A Cohort Study.

In survivors, nonfatal firearm injuries led to increases in psychiatric disorders, substance use disorders, and pain diagnoses, alongside substantial increases in health care spending and use. In addition, mental health worsened among family members. Primary funding source National Institutes of Health.

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Homicide Deaths Among Adult Cohabitants of Handgun Owners in California, 2004 to 2016 : A Cohort Study.

Living with a handgun owner is associated with substantially elevated risk for dying by homicide. Women are disproportionately affected. Primary funding source The National Collaborative on Gun Violence Research, the Fund for a Safer Future, the Joyce Foundation, Stanford Law School, and the Stanford University School of Medicine.

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In acute ischemic stroke, EVT alone vs. IV alteplase plus EVT did not differ for functional outcome at 90 d.

Source citation LeCouffe NE, Kappelhof M, Treurniet KM, et al N Engl J Med. 2021;385:1833-44. 34758251.

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In inpatients with COVID-19 who need supplemental oxygen, lenzilumab increased ventilation-free survival.

Source citation Temesgen Z, Burger CD, Baker J, et al Lancet Respir Med. 2022;10:237-46. 34863332.

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In ischemic stroke upon wakening, IV thrombolysis or EVT improves functional outcome at 90 d.

Cochrane Database Syst Rev. 2021;12:CD010995. 34850380.

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In nonhospitalized, unvaccinated adults with COVID-19, molnupiravir reduced hospitalization or death at 29 d.

Source citation Jayk Bernal A, Gomes da Silva MM, Musungaie DB, et al N Engl J Med. 2022;386:509-20. 34914868.

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In osteoporosis or osteopenia, exercise interventions improve BMD; effects vary by exercise type and BMD site.

2021. [Epub ahead of print]. 34725872.

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In severe COVID-19, high-flow vs. conventional oxygen therapy reduced intubation and time to clinical recovery at 28 d.

Source citation Ospina-Tascón GA, Calderón-Tapia LE, García AF, et al JAMA. 2021;326:2161-71. 34874419.

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In suspected PE, YEARS rule + D-dimer was noninferior to D-dimer alone to rule out PE.

Source citation Freund Y, Chauvin A, Jimenez S, et al JAMA. 2021;326:2141-9. 34874418.

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PICC vs. midline catheter use for short-term indications was linked to major complications at =30 d.

Source citation Swaminathan L, Flanders S, Horowitz J, et al JAMA Intern Med. 2022;182:50-8. 34842905.

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Lancet

Cabotegravir for the prevention of HIV-1 in women: results from HPTN 084, a phase 3, randomised clinical trial.

Funding National Institute of Allergy and Infectious Diseases, ViiV Healthcare, and the Bill & Melinda Gates Foundation. Additional support was provided through the National Institute of Mental Health, the National Institute on Drug Abuse, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development. ViiV Healthcare and Gilead Sciences provided pharmaceutical support.

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Efficacy, safety, and immunogenicity of the DNA SARS-CoV-2 vaccine (ZyCoV-D): the interim efficacy results of a phase 3, randomised, double-blind, placebo-controlled study in India.

There were two deaths (one in each group) reported at the data cutoff, neither of which was considered related to the study treatments. Interpretation In this interim analysis, ZyCoV-D vaccine was found to be efficacious, safe, and immunogenic in a phase 3 trial. Funding National Biopharma Mission, Department of Biotechnology, Government of India and Cadila Healthcare, Ahmedabad, Gujarat India.

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Pembrolizumab versus placebo as adjuvant therapy in completely resected stage IIB or IIC melanoma (KEYNOTE-716): a randomised, double-blind, phase 3 trial.

No deaths due to study treatment occurred. Interpretation Pembrolizumab as adjuvant therapy for up to approximately 1 year for stage IIB or IIC melanoma resulted in a significant reduction in the risk of disease recurrence or death versus placebo, with a manageable safety profile. Funding Merck Sharp & Dohme, a subsidiary of Merck & Co, Kenilworth, NJ, USA.

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Reduction of dietary sodium to less than 100 mmol in heart failure (SODIUM-HF): an international, open-label, randomised, controlled trial.

No safety events related to the study treatment were reported in either group. Interpretation In ambulatory patients with heart failure, a dietary intervention to reduce sodium intake did not reduce clinical events. Funding Canadian Institutes of Health Research and the University Hospital Foundation, Edmonton, Alberta, Canada, and Health Research Council of New Zealand.

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Safety of the oral factor XIa inhibitor asundexian compared with apixaban in patients with atrial fibrillation (PACIFIC-AF): a multicentre, randomised, double-blind, double-dummy, dose-finding phase 2 study.

The rate of any adverse event occurring was similar in the three treatment groups: 118 (47%) with asundexian 20 mg, 120 (47%) with asundexian 50 mg, and 122 (49%) with apixaban. Interpretation The FXIa inhibitor asundexian at doses of 20 mg and 50 mg once daily resulted in lower rates of bleeding compared with standard dosing of apixaban, with near-complete in-vivo FXIa inhibition, in patients with atrial fibrillation. Funding Bayer.

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N Engl J Med

Childhood Cardiovascular Risk Factors and Adult Cardiovascular Events.

In this prospective cohort study, childhood risk factors and the change in the combined-risk z score between childhood and adulthood were associated with cardiovascular events in midlife. (Funded by the National Institutes of Health.).

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Implanted System for Orthostatic Hypotension in Multiple-System Atrophy.

We implanted a system to restore regulation of blood pressure and enable a patient with multiple-system atrophy to stand and walk after having lost these abilities because of orthostatic hypotension. This system involved epidural electrical stimulation delivered over the thoracic spinal cord with accelerometers that detected changes in body position. (Funded by the Defitech Foundation.).

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Intersectional Analysis of U.S. Medical Faculty Diversity over Four Decades.

Census data. Even with accounting for this underrepresentation, clinical faculty and leadership positions show even starker disparities. Thoughtful policy implementation could help address this persistent underrepresentation among medical school faculty and leadership positions.

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Oral Tebipenem Pivoxil Hydrobromide in Complicated Urinary Tract Infection.

Oral tebipenem pivoxil hydrobromide was noninferior to intravenous ertapenem in the treatment of complicated urinary tract infection and acute pyelonephritis and had a similar safety profile. (Funded by Spero Therapeutics and the Department of Health and Human Services; ADAPT-PO ClinicalTrials.gov number, NCT03788967.).

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Protection by a Fourth Dose of BNT162b2 against Omicron in Israel.

Rates of confirmed SARS-CoV-2 infection and severe Covid-19 were lower after a fourth dose of BNT162b2 vaccine than after only three doses. Protection against confirmed infection appeared short-lived, whereas protection against severe illness did not wane during the study period.

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Tranexamic Acid in Patients Undergoing Noncardiac Surgery.

Among patients undergoing noncardiac surgery, the incidence of the composite bleeding outcome was significantly lower with tranexamic acid than with placebo. Although the between-group difference in the composite cardiovascular outcome was small, the noninferiority of tranexamic acid was not established. (Funded by the Canadian Institutes of Health Research and others; POISE-3 ClinicalTrials.gov number, NCT03505723.).

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Treatment for Mild Chronic Hypertension during Pregnancy.

In pregnant women with mild chronic hypertension, a strategy of targeting a blood pressure of less than 140/90 mm Hg was associated with better pregnancy outcomes than a strategy of reserving treatment only for severe hypertension, with no increase in the risk of small-for-gestational-age birth weight. (Funded by the National Heart, Lung, and Blood Institute; CHAP ClinicalTrials.gov number, NCT02299414.).

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Lancet

Acute coronary syndromes.

Dual antiplatelet therapy is recommended for 12 months following an acute coronary syndrome in most patients, and additional secondary prevention measures including intensive lipid-lowering therapy (LDL-C <1·4 mmol/L), neurohormonal agents, and lifestyle modification, are crucial. The scientific evidence for diagnosis and management of acute coronary syndromes continues to evolve rapidly, including adapting to the COVID-19 pandemic, which has impacted al aspects of care. This Seminar provides a clinically relevant overview of the pathobiology, diagnosis, and management of acute coronary syndromes, and describes key scientific advances.

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Offline: Resuscitating the white giants.

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Planetary health for the ages.

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N Engl J Med

Audio Interview: Do We Need a Fourth Dose of Covid Vaccine?

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Childhood Risk Factors and Prediction of Adult Cardiovascular End Points.

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Deliberate Practice at the Virtual Bedside to Improve Clinical Reasoning.

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In Stroke, When Is a Good Outcome Good Enough?

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Laboratory Diagnosis of Creutzfeldt-Jakob Disease.

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Omicron - Decoupling Infection from Severe Disease.

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Treating Hypertension in Pregnancy.

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Letters&Replies

Letters to the editors and authors’ replies

N Engl J Med

A Direct Measure of Tuberculosis Incidence - Effect of Community Screening.

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Chlorthalidone for Hypertension in Advanced CKD.

Pubmed   Journal   ReadQx 

Chlorthalidone for Hypertension in Advanced CKD.

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Chlorthalidone for Hypertension in Advanced CKD.

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Chlorthalidone for Hypertension in Advanced CKD. Reply.

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Evidence of Artemisinin-Resistant Malaria in Africa.

Pubmed   Journal   ReadQx 

Evidence of Artemisinin-Resistant Malaria in Africa. Reply.

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More on Carbon Monoxide Poisoning during Major U.S. Power Outages.

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More on Carbon Monoxide Poisoning during Major U.S. Power Outages. Reply.

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Protection with a Third Dose of mRNA Vaccine against SARS-CoV-2 Variants in Frontline Workers.

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Pulse Oximetry for Monitoring Patients with Covid-19 at Home - A Pragmatic, Randomized Trial.

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Others

all remaining publications eg case reports, images of the month, etc…

Ann Intern Med

Annals On Call - Evidence-Based Care of Patients With Diverticulitis.

Pubmed   Journal   ReadQx 

Firearm Injury in the United States: Time to Confront It as the Epidemic It Has Become.

Pubmed   Journal   ReadQx 

Summary for Patients: Homicide Deaths Among Adults Living With Handgun Owners in California.

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Lancet

A fortunate man?

Pubmed   Journal   ReadQx 

Afghanistan's health crisis deepens under the Taliban.

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Angela Migowa: advocating for children with rheumatic diseases.

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David Roxbee Cox.

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DNA vaccines join the fight against COVID-19.

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Gillian Hanson: UK innovator in intensive care medicine.

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Health impacts of the Russian invasion in Ukraine: need for global health action.

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Long-acting injections for HIV prevention among women in sub-Saharan Africa.

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Making anticoagulation safer.

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Mixed response to COVID-19 intellectual property waiver.

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New global WHO postnatal guidance is welcome but misses the long-term perspective.

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Reduction of dietary sodium for heart failure: a step forward.

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N Engl J Med

A Burning Question.

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A Radical Treatment for Insulin Pricing.

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After COP26 - Putting Health and Equity at the Center of the Climate Movement.

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External Ophthalmomyiasis Due to Oestrus ovis.

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Not Ready for the End Game - Why Ending Federal Covid-19 Emergency Declarations Will Harm Access to Care.

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Prone Positioning of Intubated Patients with an Elevated Body-Mass Index.

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Ten Years of Choosing Wisely to Reduce Low-Value Care.

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The Developmental Origin of Calcific Aortic Stenosis.

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Thrombectomy in Acute Ischemic Stroke.

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